How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $12.02 Typical High $12.30 | Professional | None | $6.03 | $12.02 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $13.80 Typical High $13.80 | Facility | None | $7.41 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $17.78 | Professional | None | $12.59 | $13.80 | $17.78 |
Hally Health Setting Professional Modifier None Typical Low $10.96 Median $12.30 Typical High $15.49 | Professional | None | $10.96 | $12.30 | $15.49 |
Medica Setting Facility Modifier None Typical Low $8.32 Median $13.49 Typical High $79.43 | Facility | None | $8.32 | $13.49 | $79.43 |
Medica Setting Professional Modifier None Typical Low $6.03 Median $10.47 Typical High $26.92 | Professional | None | $6.03 | $10.47 | $26.92 |
Midlands Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | None | $13.80 | $13.80 | $14.45 |
Midlands Setting Professional Modifier None Typical Low $10.47 Median $20.42 Typical High $20.42 | Professional | None | $10.47 | $20.42 | $20.42 |
United Setting Professional Modifier None Typical Low $5.13 Median $6.17 Typical High $10.72 | Professional | None | $5.13 | $6.17 | $10.72 |
Wellmark Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.02 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.02 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $1.20 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.69 | $1.20 | $1.23 |
Where Iowa sits
The same service costs 2.0 times more in Montana than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Iowa· 5th of 51
$12.02
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.